Individual provider Active NPI

Angie Dawn Brasher, SLP

  • Speech-Language Pathologist
  • Lexington, TN
National Provider Identifier
1356579320
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1915 Issued in TN
Practice address
727 E Church St
Lexington, TN 38351-1924
Phone
(731) 968-2004
NPI assigned
Jun 29, 2009
Last updated
Jun 29, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1915 TN Primary

Addresses

Primary practice location

727 E Church St
Lexington, TN 38351-1924

Mailing address

106 Mallard PT
Jackson, TN 38305-7541
Phone (731) 512-0246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1915TNMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1356579320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MALLARD PT",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057541",
            "telephone_number": "731-512-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 E CHURCH ST",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383511924",
            "telephone_number": "731-968-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASHER",
        "first_name": "ANGIE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "1915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.